Select Committee on Health Minutes of Evidence

Examination of Witnesses (Questions 211 - 219)




  211. May I welcome our second group of witnesses? We appreciate your co-operation with our inquiry and we are grateful for the written evidence we have received. Would you each briefly introduce yourself to the Committee, starting with you, Mr Gray?

  (Mr Gray) My name is Eddie Gray. I am General Manager for GlaxoSmithKline in the UK. The Committee has asked GlaxoSmithKline to appear as a separate witness but, for the Committee's information, we are members of the ABPI and I am currently a member of its Board of Management.
  (Mr McKinney) Hugh McKinney, a founder Director of Campaign for Effective and Rational Treatment (CERT).
  (Mr Campbell-Morrison) David Campbell-Morrison from Campaign for Effective and Rational Treatment.
  (Mr Fullagar) I am Bill Fullagar, currently President of the ABPI and Chairman of Novartis Pharmaceuticals.
  (Dr Jones) I am Trevor Jones. I am Director General of the ABPI.
  (Dr Patterson) John Patterson. I am President-elect of the ABPI and a member of the executive team of AstraZeneca.

  212. I am not sure whether you were present for the first session, but you will be aware we began by asking questions about the independence of NICE. I should be very interested to know your own views from different perspectives on whether NICE is genuinely independent. If it is not, why is it not and what reasons do you have for saying it is not?
  (Mr Fullagar) NICE is not independent in so far as its agenda is set for it by somebody else.

  213. Presumably you mean the Government.
  (Mr Fullagar) By the team the Government puts together to feed the agenda into it. It then has to deal with what it is handed and when it has finished that, then it hands out its recommendation in one direction or another but has no control over the way that advice is used at the current time. Thus far it does not have the freedom either to set its own agenda or to see that its recommendations are put into effect.
  (Mr Gray) Yes, our experience would be similar. The determination of the agenda and list of appraisals that NICE does are clearly something which is handed to them and is not something for which they take independent action. In our experience in the appraisal process itself they do demonstrate independence in review of appraisals and the recommendations they make.

  214. What about this point which came out in the previous session and also from some of the written submissions we have that the pharmaceutical industry is far too close to NICE? One of the areas where some of the witnesses were saying that NICE is influenced in particular is by the Department of Health and by the industry that many of you here represent.
  (Dr Patterson) NICE have been directed by the Department of Health to assess on most occasions new technologies and 70 per cent of those have been new medicines. The industry has usually just spent 10 or 12 years and $350 million developing those medicines and clearly has most of the expertise and most of the knowledge at that time on that medicine. Not surprisingly therefore, we are heavily consulted on it, but we are not at all consulted on which medicines are chosen, nor are we part of the assessment process, nor do we have, other than submitting the evidence and being able to provide that, any means of influencing the decision making process.

  215. Forgive me for appearing a bit naive, but as somebody who rarely has a day without an invitation from your industry to do one thing or another, usually involving dining or wining or something, are you telling me that there is no kind of attempt to shape the process of an evaluation in the interests of the people some of you represent here, the commercial interests?
  (Dr Patterson) My belief is that NICE fiercely guards its independence and we would respect that independence.

  216. You respect the independence.
  (Dr Patterson) Yes.

  217. Basically you are saying that there is no attempt to press them in a certain direction favourable to some of your members.
  (Dr Patterson) Individual members respond on individual technologies. When it is guidelines, then several members will respond.

  218. You say they "respond". They do not initiate.
  (Dr Patterson) They are invited to submit data.

  219. There would be no means whereby they off their own bat or their own volition would make representations of concern. This is in response to a specific invitation to be part of that evaluation process.
  (Dr Patterson) Not part of it, to submit evidence to that evaluation process.

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